[1]冉仁国,罗政,廖鑫,等.低频脉冲电磁场对骨质疏松性胸腰椎骨折内固定术后康复的促进作用[J].中华老年骨科与康复电子杂志,2024,(01):39-45.[doi:10.3877/cma.j.issn.2096-0263.2024.01.007]
　Ran Renguo,Luo Zheng,Liao Xin,et al.Promoting effect of low-frequency pulsed electromagnetic field on postoperative rehabilitation of osteoporotic thoracolumbar fractures treated with internal fixation[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2024,(01):39-45.[doi:10.3877/cma.j.issn.2096-0263.2024.01.007]
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低频脉冲电磁场对骨质疏松性胸腰椎骨折内固定术后康复的促进作用()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2024年01期
页码:
39-45
栏目:
康复
出版日期:
2024-02-05

文章信息/Info

Title:
Promoting effect of low-frequency pulsed electromagnetic field on postoperative rehabilitation of osteoporotic thoracolumbar fractures treated with internal fixation
作者:
冉仁国; 罗政; 廖鑫; 张付民
445000 恩施土家族苗族自治州中心医院脊柱外科
Author(s):
Ran Renguo;  Luo Zheng;  Liao Xin;  Zhang Fumin
Department of Spinal Surgery, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, Enshi 445000, China
关键词:
低频脉冲电磁场;  骨质疏松症;  胸腰椎骨折;  内固定术;  骨密度
Keywords:
Low-frequency pulsed electromagnetic field;  Osteoporosis;  Osteoporotic thoracolumbar fractures;  Internal fixation;  Bone density
DOI:
10.3877/cma.j.issn.2096-0263.2024.01.007
文献标志码:
A
摘要:
目的 探讨低频脉冲电磁场对骨质疏松性胸腰椎骨折内固定术后康复的促进作用。方法 将118例骨质疏松性胸腰椎骨折内固定术后患者采用随机数字表分两组。对照组给予唑来膦酸治疗，观察组给予低频脉冲电磁场联合唑来膦酸治疗。对比两组患者疼痛程度，骨折愈合时间，治疗前后的骨密度，骨代谢指标水平与腰椎功能评分变化。结果 111例患者均获得完整随访，随访率94.07%，随访时间6～12个月，平均（9.00±1.08）个月。其中观察组男20例、女37例，年龄50～83岁，平均（64.50±5.65）岁；对照组男18例、女36例，年龄50～83岁，平均（64.05±5.82）岁。观察组和对照组不同时刻疼痛评分进行重复测量设计的方差分析显示，观察组和对照组组间差异有统计学意义[观察组：（8.51±0.79）分、（5.72±0.65）分、（2.86±0.41）分，对照组：（8.96±0.91）分、（6.38±0.72）分、（4.77±0.53）分]（F=12.451，P＜0.001），组别与时间点间存在交互作用（F=11.338，P＜0.001），各时间点两组差异均有统计学意义（F=2.786、5.074、21.301，P=0.006、＜0.001、＜0.001）；观察组在各时间点间差异均有统计学意义（F=18.967，P＜0.001）；观察组骨折愈合时间短于对照组[（12.31±2.07）周比（14.76±2.25）周]（t=6.125，P＜0.001）；观察组和对照组治疗前与治疗6个月后在腰椎（L1～L4）骨密度、N-MID、β-CTx和PINP水平及腰椎功能障碍评分[观察组：（0.65±0.07）g/cm2与（0.71±0.08）g/cm2、（15.58±3.01）ng/mL与（8.82±1.23）ng/mL、（0.32±0.06）ng/mL与（0.13±0.02）ng/mL、（32.89±4.33）ng/mL与（54.56±7.37）ng/mL、（60.18±5.20）分与（15.88±3.01）分；对照组：（0.64±0.06）g/cm2与（0.67±0.07）g/cm2、（15.43±2.96）ng/mL与（11.24±1.74）ng/mL、（0.31±0.06）ng/mL与（0.19±0.04）ng/mL、（33.02±4.41）ng/mL与（41.23±6.06）ng/mL、（59.25±5.43）分与（24.35±4.20）分]，进行重复测量设计的方差分析显示，观察组和对照组组间差异有统计学意义（F=12.401、15.468、18.742、16.229、18.924，均P＜0.001），组别与时间点间存在交互作用（F=8.065、12.224、18.965、22.467、14.881，均P＜0.001），治疗前两组差异均无统计学意义，治疗6个月后两组差异均有统计学意义（F=2.894、8.750、10.318、10.738、10.330，均P＜0.05）；观察组在治疗前与治疗6个月后差异均有统计学意义（F=2.924、19.286、22.569、36.385、12.387，均P＜0.05）。结论 低频脉冲电磁场在骨质疏松性胸腰椎骨折内固定术后能够有效缓解患者骨质疏松疼痛，缩短骨折愈合时间，提高骨密度，改善骨代谢，还可提高腰椎功能。
Abstract:
Objective To promoting effect of low-frequency pulsed electromagnetic field on postoperative rehabilitation of osteoporotic thoracolumbar fractures treated with internal fixation. Methods 118 patients with osteoporotic thoracolumbar fractures undergoing internal fixation were divided into 2 groups by a random digital table. The control group was given zoledronic acid, while the observation group was given low-frequency pulsed electromagnetic field combined with zoledronic acid. The pain degree, fracture healing time, the levels of bone density, indicators of bone metabolism and lumbar function before and after treatment were compared between the two groups. Results 111 patients received complete follow-up, with a follow-up rate of 94.07%. The follow-up time was 6-12 months, with an average of (9.00±1.08) months. The analysis of variance of repeated measurement design for pain scores at different time points between the observation group and the control group showed statistically significant differences between the observation group and the control group [observation group: (8.51±0.79) scores, (5.72±0.65) scores, (2.86±0.41) scores, control group: (8.96±0.91) scores, (6.38±0.72) scores, (4.77±0.53) scores] (F=12.451, P<0.001) . There was an interaction between the groups and time points (F=11.338, P<0.001), and the differences between the two groups at each moment were statistically significant (F=2.786, 5.074, 21.301, P=0.006, <0.001, <0.001). The differences in the observation group between each two moments were statistically significant (F=18.967, P<0.001) . The fracture healing time in the observation group was shorter than that in the control group [(12.31±2.07) weeks vs (14.76±2.25) weeks] (t=6.125, P<0.001) . The analysis of variance of repeated measurement design for the bone density, N-MID, β-CTx and PINP levels and lumbar dysfunction scores showed statistically significant differences between the observation group and the control group [observation group: (0.65±0.07) g/cm2 and (0.71±0.08) g/cm2, (15.58±3.01) ng/mL and (8.82±1.23) ng/mL, (0.32±0.06) ng/mL and (0.13±0.02) ng/mL, (32.89±4.33) ng/mL and (54.56±7.37) ng/mL, (60.18±5.20) scores and (15.88±3.01) scores; control group: (0.64±0.06) g/cm2 and (0.67±0.07) g/cm2, (15.43±2.96) ng/mL and (11.24±1.74) ng/mL, (0.31±0.06) ng/mL and (0.19±0.04) ng/mL, (33.02±4.41) ng/mL and (41.23±6.06) ng/mL, (59.25±5.43) scores and (24.35±4.20) scores ](F=8.065, 12.224, 18.965, 22.467, 14.881, all P<0.001) , and there was interaction between the groups and moments (F=12.401, 15.468, 18.742, 16.229, 18.924, all P<0.001). There was no statistically significant difference between the two groups before treatment, while there was a statistically significant difference between the two groups after 6 months of treatment (F=2.894, 8.750, 10.318, 10.738, 10.330, all P<0.05) . The observation group showed statistically significant differences before and after 6 months of treatment (F=2.924, 19.286, 22.569, 36.385, 12.387, all P<0.05). Conclusion Low-frequency pulsed electromagnetic field can effectively relieve osteoporosis pain pain, shorten fracture healing time, increase bone density and improve bone metabolism after internal fixation of osteoporotic thoracolumbar fractures, which can also improve lumbar function.

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备注/Memo

备注/Memo:
基金项目：湖北省科技厅自然科学基金项目（2019CFB615）
更新日期/Last Update: 2024-08-01